Fetal Cell Transplants Can Work for Parkinson's

Researchers Say Alternate Cell Sources Needed

By Jim Morelli
WebMD Medical News

Nov. 22, 1999 (Atlanta) -- It's still an investigational procedure -- as
well as a controversial one -- but for the first time, researchers have
evidence that brain cells transplanted from fetal tissue into the brain of
a Parkinson's disease patient work as intended. That is, the cells store
and release dopamine -- a chemical that allows the smooth movement
of muscles. It is the lack of dopamine that is thought to contribute to
the rigidity and tremors seen in the disease.

"The importance of this study is that we've been able to demonstrate
that the implant works," says lead author Paolo Piccini, MD, a
neurologist at Imperial College School of Medicine, Hammersmith
Hospital, London. "The next step is to find an alternative to fetal cells."

Five healthy subjects and one Parkinson's patient -- a 59-year-old man
who underwent a fetal cell transplant to a part of the right side of his
brain some 10 years ago, after his symptoms had become debilitating
-- participated in the study. Physically, his recovery was dramatic.
Within three years, he was able to stop taking his medication, called
L-dopa, and after about five years he discontinued therapy to prevent
rejection of the transplanted cells.

The patient was put back on a low dose of L-dopa about six years
after the surgery -- but Piccini says it's because the disease began to
affect the left side of his brain, which didn't get a fetal cell transplant.
That's the dose he remains on today -- with just an intermittent
tremor and only slight problems with muscular movements.

Piccini says follow-up tests showed that the operation works, but only
in some patients and not in others. "If the operation does not improve
the patient," she says, "the operation has not been performed
properly. Many things can go wrong. The cells need to be the right age
and prepared very carefully."

Of course, the real question is whether the operation can ever become
widely available -- given that the current source of the transplant cells
is aborted fetuses. Piccini says she's confident alternate sources will
be found. Research is currently looking into the possible use of animal
cells, especially from pigs -- as well as human cells from other sources.
"When we have a different source of cells," she says, "it will become
available to a large number of patients."



Vital Information:

New evidence shows that fetal tissue transplanted in the brain of
a Parkinson's patient does work by storing and releasing
dopamine, which allows the smooth movement of muscles.
The patient who participated in this study has been essentially
symptom-free, with only a mild adjustment in his medication for
the 10 years since the procedure.
While the operation may not ever be widely available with the
current source of tissue -- aborted fetuses -- one researcher
believes that other sources of cells, either from animals or
humans, will be developed to make the operation more feasible.